|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 3 | Page : 229-230
Infant feeding at the time of COVID-19: Is it safe to breastfeed?
Rafat Mohammed Mosalli
Department of Pediatrics, Medical College, Umm Al-Qura University, Mecca; Department of Pediatrics, International Medical Center, Jeddah, Saudi Arabia
|Date of Submission||08-May-2020|
|Date of Decision||24-Jun-2020|
|Date of Acceptance||28-Jun-2020|
|Date of Web Publication||07-Aug-2020|
Dr. Rafat Mohammed Mosalli
Department of Pediatrics, Umm Al-Qura University, P.O. Box 7607, Mecca
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mosalli RM. Infant feeding at the time of COVID-19: Is it safe to breastfeed?. J Clin Neonatol 2020;9:229-30
Recommendations regarding mother–infant contact and breastfeeding for mothers with COVID-19 are quite conflicting. Most reports and recommendations, however, acknowledge that postpartum contact with and breastfeeding might present potential risks for viral transmission from mothers with COVID-19 through respiratory droplet. Health-care providers might judge on what in their opinion is ideal without considering parental decision about separation and feeding plan. In a recent letter, Almudeer states Based on the current and available data, breastfeeding benefits outweigh any potential risks of transmission of the virus through breastmilk, without giving further details about the possible impact of virus transmission through direct breastfeeding and without seeking parental shared decision in order to comprehend this risk and perhaps explore other feeding options. We can assume at least some of the reasons behind selecting this choice: the undoubted protective benefits of breastfeeding together with lack of data supporting virus excretion in breast milk. The current data, however, are still insufficient and should be carefully indorsed. To determine their best feeding option, both health-care providers and parents should fully understand the current evidence regarding potential risk of COVID transmission, maternal–newborn health status and hospital resources. Accordingly, there might be four possible feeding options: (1) expressed breast milk, (2) accepting the potential risk of direct breastfeeding, (3) bottled formula, and (4) donor milk. Natural or accepted medications for milk suppression may also be considered if the mother chooses not to breastfeed. Mothers with COVID-19 who are still considering breastfeeding should follow the Centers for Disease Control and Prevention infection control protocol before and after touching their baby., Alternatively, mother can express her breast milk during temporary separation, using a dedicated breast pump, as well as hand hygiene and thorough cleaning of the pump and its parts or bottle parts.,
When a mother with COVID-19 is too sick to care for the newborn, the neonate will be managed separately and fed fresh expressed breast milk by designated healthy caregiver who should implement strict droplet, airborne and contact precautions until newborn SARS-CoV-2 PCR test results are available.,
A donor human milk, though sounds an attractive option, might be impossible, given the social distancing and other constraint measures during the curfew.
In summary, health-care providers might encounter an infant born to a mother with suspected or confirmed COVID-19 for which postpartum contact and/or breastfeeding might present potential risks of viral transmission, while the beneficial effects of breastfeeding are fully recognized universally, a well-balanced discussion with the parents for or against breastfeeding should be an informed decision and address the followings: risks and benefits of breastfeeding, including the limited available data on excretion of virus through breast milk, potential presence of viral antibodies, risks of infection via health-care providers and the care needed during handling the neonate to avoid infection, as well as the alternative feeding options such as expressed breast milk, donor milk (if available) and/or formula.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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